Method of diagnosis and treatment of tumors using high intensity focused ultrasound

Abstract

A method of diagnosis and treatment of tumors using High Intensity Focused Ultrasound is provided. The method of diagnosing the presence of a tumor in a patient comprises the steps of subjecting a tumor to high intensity focused ultrasound (HIFU) to cause the tumor cells to release cellular material and evaluating the cellular material for a tumor marker. The method of treating a tumor in a patient can also comprise the step of subjecting a tumor to high intensity focused ultrasound (HIFU) to provoke an immune response.

1 . A method of diagnosing the presence of a tumor in a patient, the method comprising the steps of:
 subjecting a tumor to high intensity focused ultrasound (HIFU) to cause the tumor cells to release cellular material; and   evaluating the cellular material for a tumor marker.   
     
     
         2 . The method of  claim 1 , wherein the HIFU is a high energy, high intensity focused ultrasound (HI-HIFU). 
     
     
         3 . The method of  claim 1 , wherein the HIFU is a low energy, high intensity focused ultrasound (LO-HIFU). 
     
     
         4 . The method of  claim 1 , wherein the HIFU is administered as a combination of HI-HIFU and LO-HIFU. 
     
     
         5 . The method of  claim 1 , wherein the tumor is subjected to HIFU that is applied continuously for about 3 to 20 seconds. 
     
     
         6 . The method of  claim 1 , wherein the tumor is subjected to HIFU that is applied as a pulse with a pulse duration of about 1 to 100 milliseconds. 
     
     
         7 . The method of  claim 3 , wherein the tumor is subjected to LO-HIFU by moving a HIFU focus across a tumor. 
     
     
         8 . The method of  claim 2 , wherein the tumor is subjected to HI-HIFU that moves across a tumor. 
     
     
         9 . The method of  claim 1 , wherein the tumor is subjected to more than one application of HIFU. 
     
     
         10 . The method of  claim 1 , wherein the time between subjecting the tumor to HIFU and evaluating the cellular material is about 24 to 48 hours. 
     
     
         11 . The method of  claim 1 , wherein the HIFU causes necrosis of the tumor. 
     
     
         12 . The method of  claim 1 , wherein the HIFU does not cause necrosis of the tumor. 
     
     
         13 . The method of  claim 1 , wherein the HIFU causes necrosis of a portion of the tumor. 
     
     
         14 . The method of  claim 2 , wherein the HI-HIFU applies power in the amount of about 1.3 to 2.0 KW per cm 2 . 
     
     
         15 . The method of  claim 2 , wherein the HI-HIFU has an operating frequency of about 1.0 to 5.0 MHz. 
     
     
         16 . The method of  claim 2 , wherein the HI-HIFU has an operating frequency greater than about 20 KHz and less than about 100 MHz. 
     
     
         17 . The method of  claim 3 , wherein the LO-HIFU applies power in the amount of about 0.5 KW per cm 2 . 
     
     
         18 . The method of  claim 3 , wherein the LO-HIFU applies energy in the amount of about 0.01 to 3.0 KW-seconds per cm 2 . 
     
     
         19 . The method of  claim 3 , wherein the LO-HIFU operates with a pulse having a duration of about 0.01 to 1.0 seconds with pulse repetition frequencies of about 0.5 to 5.0 Hz. 
     
     
         20 . The method of  claim 3 , wherein the LO-HIFU operates with repetition frequencies of about 0.5 to 30.0 Hz. 
     
     
         21 . The method of  claim 8 , wherein the HI-HIFU operates with repetition frequencies of about 0.5 to 30.0 Hz. 
     
     
         22 . The method of  claim 1 , wherein the biological fluid is one of blood, urine, and saliva. 
     
     
         23 . The method of  claim 1 , wherein the tumor marker is a protein. 
     
     
         24 . The method of  claim 1 , wherein at least one of the presence and level of the tumor marker is obtained prior to application of the HIFU and is compared to at least one of the presence and level of the tumor marker after the application of the HIFU. 
     
     
         25 . The method of  claim 1 , wherein the HIFU is applied in one of the following approaches: extracorporeal, infra cavity, percutaneous, robotic, laparoscopic, and directly on the tumor. 
     
     
         26 . The method of  claim 1 , wherein the HIFU is applied using one or more of intensity modulation and frequency modulation. 
     
     
         27 . The method of  claim 6 , wherein the frequency of the HIFU is greater than about 20 KHz and less than about 100 MHz. 
     
     
         28 . A method of treating a tumor in a patient, the method comprising the step of subjecting a tumor to high intensity focused ultrasound (HIFU), wherein the application of HIFU provokes an immune response. 
     
     
         29 . The method of  claim 28 , wherein the HIFU is a high energy, high intensity focused ultrasound (HI-HIFU). 
     
     
         30 . The method of  claim 28 , wherein the HIFU is a low energy, high intensity focused ultrasound (LO-HIFU). 
     
     
         31 . The method of  claim 28 , wherein the HIFU is administered as a combination of HI-HIFU and LO-HIFU. 
     
     
         32 . The method of  claim 28 , wherein the tumor is subjected to HIFU that is applied continuously for about 3 to 20 seconds. 
     
     
         33 . The method of  claim 28 , wherein the tumor is subjected to HIFU that is applied as a pulse with a pulse duration of about 1 to 100 milliseconds. 
     
     
         34 . The method of  claim 30 , wherein the tumor is subjected to LO-HIFU by moving a HIFU focus across a tumor. 
     
     
         35 . The method of  claim 29 , wherein the tumor is subjected to HI-HIFU that moves across a tumor. 
     
     
         36 . The method of  claim 28 , wherein the tumor is subjected to more than application of HIFU. 
     
     
         37 . The method of  claim 28 , wherein the HIFU causes necrosis of the tumor. 
     
     
         38 . The method of  claim 28 , wherein the HIFU does not cause necrosis of the tumor. 
     
     
         39 . The method of  claim 28 , wherein the HIFU causes necrosis of a portion of the tumor. 
     
     
         40 . The method of  claim 29 , wherein the HI-HIFU applies power in the amount of about 1.3 to 2.0 KW per cm 2 . 
     
     
         41 . The method of  claim 29 , wherein the HI-HIFU has an operating frequency of about 1.0 to 5.0 MHz. 
     
     
         42 . The method of  claim 29 , wherein the HI-HIFU has an operating frequency greater than about 20 KHz and less than about 100 MHz. 
     
     
         43 . The method of  claim 30 , wherein the LO-HIFU applies power in the amount of about 0.5 KW per cm 2 . 
     
     
         44 . The method of  claim 30 , wherein the LO-HIFU applies energy in the amount of about 0.01 to 3.0 KW-seconds per cm 2 . 
     
     
         45 . The method of  claim 30 , wherein the LO-HIFU operates with a pulse having a duration of about 0.01 to 1.0 seconds with pulse repetition frequencies of about 0.5 to 5.0 Hz. 
     
     
         46 . The method of  claim 30 , wherein the LO-HIFU operates with repetition frequencies of about 0.5 to 30.0 Hz. 
     
     
         47 . The method of  claim 35 , wherein the HI-HIFU operates with repetition frequencies of about 0.5 to 30.0 Hz. 
     
     
         48 . The method of  claim 28 , wherein the HIFU is applied in one of the following approaches: extracorporeal, infra cavity, percutaneous, robotic, laparoscopic, and directly on the tumor. 
     
     
         49 . The method of  claim 28 , wherein the HIFU is applied using one or more of intensity modulation and frequency modulation. 
     
     
         50 . The method of  claim 33 , wherein the frequency of the HIFU is greater than about 20 KHz and less than about 100 MHz. 
     
     
         51 . The method of  claim 28 , wherein low energy, high intensity focused ultrasound (LO-HIFU) is administered before high energy, high intensity focused ultrasound (HI-HIFU). 
     
     
         52 . The method of  claim 28 , wherein the immune response is directed to diseased tissue other than the tumor subjected to the HIFU. 
     
     
         53 . The method of  claim 28 , wherein the immune response is enhanced by administering an immunomodulatory compound. 
     
     
         54 . The method of  claim 53 , wherein the administration of the immunomodulatory compound includes proving at least one immunomodulatory molecule. 
     
     
         55 . The method of  claim 54  wherein the immunomodulatory molecule is a cytokine. 
     
     
         56 . The method of  claim 55 , wherein the cytokine is a dendritic cell-stimulating cytokine. 
     
     
         57 . The method of  claim 55 , wherein the cytokine is selected from the group consisting of G-CSF and GM-CSF. 
     
     
         58 . The method of  claim 55 , wherein the cytokine is selected from the group consisting of chemokines, lymphokines and interleukins. 
     
     
         59 . The method of  claim 53 , wherein the administration of the immunomodulatory compound comprises delivering to the patient an effective amount of a composition that stimulates the immune system of the patient. 
     
     
         60 . The method of  claim 55 , wherein the cytokine is a T lymphocyte-stimulating cytokine. 
     
     
         61 . The method of  claim 58 , wherein the T lymphocyte-stimulating cytokine is IL-2 or IL-15. 
     
     
         62 . The method of  claim 54 , wherein the immunomodulatory molecule is CD40L. 
     
     
         63 . The method of  claim 54 , wherein the immunomodulatory molecule is a molecule is a chemokine. 
     
     
         64 . The method of  claim 54 , wherein the immunomodulatory molecule is a molecule that down-regulates regulatory T-cells. 
     
     
         65 . The method of  claim 64 , wherein the immunomodulatory molecule is an anti-CTLA4 antibody. 
     
     
         66 . The method of  claim 54 , wherein the immunomodulatory molecule is 4-1 BB ligand. 
     
     
         67 . The method of  claim 54 , wherein the immunomodulatory molecule is a CpG oligonucleotide. 
     
     
         68 . The method of  claim 54 , wherein the composition comprises an anti-tumor vaccine. 
     
     
         69 . The method of  claim 54 , wherein the vaccine comprises an autologous tumor cell vaccine.